Glenn et al used a scale to describe the level of apathy shown by a patient. This can be used to evaluate a patient and to help communicate the patient's clinical status. The authors are from rehabilitation centers in Boston (Harvard, Northeastern University, Spaulding Hospital, Hebrew Rehabilitation Center).
Disorders with apathy:
(1) after severe head injury
(2) after stroke
(3) with schizophrenia, depression or other psychiatric conditions
(4) drug-associated
Parameters:
(1) initiation of activity
(2) voluntary movement (kinetics)
(3) emotions
Initiation of Activity
Voluntary Movement
Emotions
Scale
moderate or frequent
eukinetic or hyperkinetic
demonstrative or well-modulated
1
moderate or frequent
eukinetic or hyperkinetic
demonstrative or well-modulated, but complains of apathy
2
modest but regular
mildly akinetic
mild indifference
3
infrequent
moderately akinetic
moderate indifference
4
rare
only in response to environmental cues or bodily needs
rare or no display of even minor emotional response
5
rare
rare
rare or no display of even minor emotional response
6
never
akinetic even when uncomfortable
no evidence of emotional responsiveness
7
from Table 2, page 512
where:
• Rare or absent emotional display covers several scale levels. In the implementation I made no display a feature for level 7 alone.
Interpretation:
• A scale value of 1 is essentially normal.
• A scale value of 7 indicates an akinetic mute or vegetative state.
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